Setting A dynamic cohort of university graduates (SeguimientoUniversidad de Navarra/University of Navarra Follow-up [SUN]Project).

Participants A total of 10 094 initially healthySpanish participants from the SUN Project participated in thestudy. Recruitment began on December 21, 1999, and is ongoing.

Main Outcome Measure Participants were classified as havingincident depression if they were free of depression and antidepressantmedication at baseline and reported a physician-made diagnosisof clinical depression and/or antidepressant medication useduring follow-up.

Results After a median follow-up of 4.4 years, 480 newcases of depression were identified. The multiple adjusted hazardratios (95% confidence intervals) of depression for the 4 uppersuccessive categories of adherence to the MDP (taking the categoryof lowest adherence as reference) were 0.74 (0.57-0.98), 0.66(0.50-0.86), 0.49 (0.36-0.67), and 0.58 (0.44-0.77) (P for trend fruit and nuts, the monounsaturated- to saturated-fatty-acidsratio, and legumes.

Conclusions Our results suggest a potential protectiverole of the MDP with regard to the prevention of depressivedisorders; additional longitudinal studies and trials are neededto confirm these findings.

An interesting article. But, I have to ask why so many Greeks and Italians suffer from depression ? In fact depression is a major problem throughout the mediterranean, even with the higher level of sunlight hours.

I'd like to see some studies done on the Mediterranean (and other) diet(s) with the ethnic/racial background of the participants kept in mind.

What I wonder is, for instance, would the Mediterranean diet (which is a very tasty one in my opinion, btw!) really reduce depression for, say, Irish people who have been consuming dairy products and meat for something like, what?, 6000+ years. You think we'd be well adapted to it by now.

Maybe the Mediterranean diet works really well for, you know, Mediterranean peoples -- and other diets might be suitable for other peoples.

J, would you say diet is the reason for low suicide rates in Greece, Israel and other Med countries, or is the real reason family structure, that strong communication culture which does not encourage excessive competition amongst siblings, and reinforces the responsibility of the family to care for the elderly ?

Aren't they being a little circular in their reasoning? People who are getting depressed are more likely to devour comfort food (and hit the bottle) than medicate themselves at the salad bar. Or, as a friend just said, "...the idea of someone like Bessy Smith singing 'I was so blue I had to eat a tomato', has its charm."

Look at Japan, which has a healthier diet than the med diet, full of fish based omega 3, low in saturated fat, and full of vegetables. Yet, Japan has amongst the highest suicide rates in the world. Japan also has one of the most rigid social systems in the world, with little inner-family communication, or support.

Let me add, that, besides Okinawa, Japan has a terrible problem with mental health. The difference, is that it is hidden.

Let me add one last point. The med diet may be beneficial for cardiovascular disease, but obesity rates amongst affluent populations throughout the med, is staggering. In line with this obesity problem, is also found high cancer rates related to excessive fatness. This is especially so in females, - breast cancer, ovarian cancer, and reproductive cancers, and fibroids, which are more likely hood is a result of the high blood serum oestrogen levels, resulting from excessive adipocyte aromatization.

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